The Centers for Disease Control and Prevention estimates that 48 million people or 1 in 6 Americans experience a foodborne illness every year as a result of consuming contaminated food or drink and roughly 128,000 people in the US are hospitalized due to foodborne illness. There are many different pathogens or disease causing microbes that can cause illness. Currently, there are 250 known pathogens that are responsible for 20% of the reported foodborne cases and the root cause of the remaining 80% of all cases are many unknown pathogens. Additionally, chemical contaminates such as pesticides can cause foodborne illness. In the US, the top five pathogens that cause foodborne illnesses are norovirus (58%), salmonella (10%), Clostridium perfringes (10%), and campylobacter (9%). However, salmonella infections are responsible for the most hospitalizations and for the most deaths out of any of the foodborne pathogens.

What is a Pathogen?

Foodborne pathogens can cause several different types of illness. Salmonella and noroviruses can cause illness by consumption of live pathogens that replicate and grow in the intestinal tracks which is called a foodborne infection. An organism like Bacillus cereus (a pathogen found in rice and grains) can cause illness through foodborne intoxication through the production of toxins and the live bacteria does not need to be consumed. These microorganisms typically do not make the food look, taste or smell bad so it impossible to determine if the food is contaminated.

For a pathogen to grow and proliferate, certain conditions must be met. The first one condition is that the pathogen or its toxin must be in the food. Many raw foods have naturally occurring background levels of pathogen contamination. These pathogens can thrive when the temperature and the nutrients are suitable for the pathogenic growth. Foods that are high in protein such as eggs, meat, fish, and milk can provide appropriate nutrient levels for pathogens. Additionally, foods that are slightly acidic (pH levels 4.6-7.6) also support microbiological growth. Additionally, foodborne pathogens grow best in foods that have a temperature of 70-104° F. It is essential that hot foods must be kept hot and cold foods must be kept cold to prevent growth. Common food service foods that have a higher risk of foodborne illness are rice, cooked or raw animal products, cooked or raw vegetables, raw seed sprouts, raw shell eggs or water cooled hard boiled eggs, cut melons, and garlic and oil mixtures.

Once a pathogen has been allowed to proliferate in a food, foodborne illness can set in following consumption of the contaminated food. Most foodborne illnesses can occur with 2-24 hours following consumption of the contaminated food but symptoms have been reported as far out as 30 days post-contaminated food consumption. The time of onset of foodborne illness symptoms can be pathogen dependent. The most common symptom is diarrhea but symptoms can include vomiting, cramping, fever, and flu like symptoms.

Prevent the problem before it happens

To avoid potential problems in foods, it is very important to control or eliminate pathogens in food products. HACCPS or hazard analysis and critical control points are your quality assurance and risk assessment steps. They include coming up with preventative measures; evaluating critical control points and preventing, eliminating or reducing risk; evaluating and establishing critical limits such as cooking temperatures; monitoring CCP’s with temperature measurements; corrective action; record keeping systems; and verification.

SOPs and employee education are essential in preventing foodborne illnesses. The SOPs should address everything from where the product can be ordered from to how it is received, how it is stored, how long it is stored, how it is prepared, where it is prepared, by whom it is prepared, how it is transported and how it is served. Comprehensive SOPs go a long way to not only preventing foodborne illness, but also defending claims. However, that is only if they are adhered to. Employee training should be conducted on a continuous basis and management should continually verify SOPs are being followed. There are also several training certifications in food handling such as those offered through ServSafe and Learn2Serve. These can be done online and provide management with valuable education in developing safe food handling protocols.

Summary

While a foodborne illness outbreak can be devastating to a restaurant there is no restaurant that in a single night can serve as many individuals as a hotel during a large conference banquet or buffet. Many foodborne illness claims originate from that exact setting. Often times there are numerous individuals who become ill. The assumption is that there must have been some adulterated food item they all consumed that made them sick. It could not possibly be a coincidence… but it could be something other than a foodborne illness! Reaction time and record keeping is crucial in defending these claims.

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Authors

Allison Stock – Principal Consultant/Toxicologist & Epidemiologist, Rimkus Consulting Group
astock@rimkus.com
504-832-8999

Dr. Allison Stock is an internationally known toxicologist and epidemiologist with 25 years of toxicological, epidemiological, regulatory, and environmental experience. Her background is supported by experience in the federal and state government and industry (small and Fortune 500 companies).

Dr. Stock specializes in human health risk assessments combing both toxicological and epidemiological data. She has expertise in petrochemicals, oil and gas, environmental permitting, property transfer, environmental, social, and health impact assessments, inhalation toxicology, renal toxicology, toxicological and epidemiological risk assessment, communicable and foodborne illnesses such as Legionellosis, E. coli infections, and Salmonellosis, rapid needs assessments, emergency response, ambient and indoor air exposure assessments including mold, particulate matter, and asbestos, occupational health and safety plans, drug and alcohol intoxications, and stakeholder communications.

Kari Jacobson – Shareholder, La Cava & Jacobson
kjacobson@lacavajacobson.com
(813) 209-9611

Kari Katzman Jacobson is a shareholder of La Cava & Jacobson, P.A. Born in Miami, Florida in 1967 she graduated from the University of Florida with a B.A. in 1989 and from the University of Miami School of Law with a J.D. in 1992. Ms. Jacobson began her career as a prosecutor, and then went on to defend self-insured companies, insurance companies and those whom they insure.

Ms. Jacobson was admitted to The Florida Bar in 1992 and has been admitted to the U.S. District Court, Middle District of Florida since 1994. She is a member of The Florida Bar Association; American Bar Association, Hillsborough County Bar Association, Collier County Bar Association and the Claims and Litigation Management Alliance. She is also a member of The Federation of Defense & Corporate Counsel. She is A.V. Peer Review Rated by Martindale-Hubbell.

Ms. Jacobson is certified by the Florida Supreme Court as a Circuit Civil Mediator. Her practice is primarily concentrated in the areas of general liability, premises liability, negligent security, construction litigation, professional liability, trucking and commercial freight defense litigation claims.

A CPTED survey identifies exposures within the enterprises built and natural environments and recommends enhancements that reduce risks to people, operations and facilities. The survey is a component of the risk assessment process and focuses on identifying human behaviors, along with other potential exposures within specific areas. Survey findings identify solutions that, if implemented, enhance the safety and security of various industries

CPTED involves the design use of five strategies: natural surveillance; natural access control; territorial reinforcement (using buildings, fences, pavement, signs and landscaping to express ownership); activity support (placing the right activity in the space); and maintenance (addressing the inspection, repair and general housekeeping of the space). Accepted CPTED industry strategies are described below:

• Natural surveillance. This strategy involves reducing crime by decreasing target opportunities in a space/area by placing physical features, activities and people to maximize visibility.
• Natural access control. Channeling people into, alongside or out of spaces/areas and deterring entry elsewhere along the boundary are the concepts of this principle (through the judicial placement of entrances, exits, fencing, landscaping and lighting); This concept denies access to crime targets and creates a perception of risk for adversaries.
• Territoriality. Territoriality notifies users and non-users of the boundaries of a space/area or facility. It creates a psychological deterrent to crime by notifying users of the space/area/facility that they are being watched and that the community is the space/area/facility for purposeful activities.

Other CPTED Elements
Maintenance and activity support aspects have been added to CPTED as of recent, but are often treated separately because they are not physical design elements within the built environment.

• Activity support. By encouraging authorized activities in public spaces, guests of a business understand its intended use. Criminal acts are discouraged, and an increase in safety and security of the immediate area is realized.
• Maintenance. Care and upkeep demonstrates expression of ownership for the intended purpose of the area. A lack of care indicates loss of control of a space or area and can be a sign of tolerance for disorder. The Broken Windows Theory is a valuable tool in understanding the importance of maintenance in deterring crime. Broken Windows theory proponents support a zero tolerance approach to property maintenance, observing that the presence of a broken window will entice vandals to break more windows in the vicinity. The sooner broken windows are fixed, the less likely it is that such vandalism will occur in the future. Establishing care and maintenance standards and continuing the service preserves the intended use of the space/area. CPTED maintenance and care standards also safeguard the best interests of the community and the enterprise.

At today’s business meetings, conventions, and trade shows, the destination venue plays a key role in attracting attendees—sometimes as much as the agenda. The first thing at a prime hotel or meeting venue to grab your attention is the landscape: beautiful flowers that you only wish were in your home or office, gorgeous palm trees whose trunks look like they were hand-cut into the shape of diamonds, green rolling hedges, flowering trees, variegated shrubs, and a carefully-manicured carpet of green grass. What a sight! You feel compelled to walk upon it, smell it, and touch it, connecting with your instinctual imperative to bond with nature. However, be warned: There are hidden dangers lurking in such a pristine landscape. The following real-life cases serve as cautionary tales for those who would dismiss or ignore these hazards.

Thirty-One Flavors

After finally making up his young mind on which flavor of ice cream he desires, a little boy and his father must now decide where they will sit to enjoy their culinary delight. Wait, there’s the perfect spot! As the boy and his dad bond over their ice cream, nestled in the shade of a multi-stemmed palm tree, an invisible lack of structural strength is eroding the ability of the palm trunk to support itself. Without warning, the tree falls and lands on the little boy. During the investigation that followed this tragedy, the trunk remnant reveals a very specific variety of mushroom: a basidiocarp, the fruiting flower of the disease that caused the tree to fall, and a very obvious sign of trouble in a palm tree for the knowing eye.

 To Build a Fire

Few can deny the joy of camping in the woods. There are some basic decisions to be made, like where to place the camping chairs so that the smoke from the camp fire does not disrupt the enjoyment. In this case, the loud and sharp cracking noise of the decayed trunk buckling under its own weight was not understood soon enough as the 70 foot monster-sized tree crashed upon a chair’s occupant. A cavity was found in the trunk measuring four feet in length and at least eight inches in depth.

 When It Rains, It Pours

A woman in the midst of a brilliant career decided to make a run for it during a mosoon instead of staying in the gift shop and waiting it out. After a newly-installed palm tree fell and crushed the woman (who survived but was seriously injured), a number of experts testified that the problem was the number of temporary stakes propping up the palm tree. One expert opined that three stakes is enough to provide structural support. Another expert stated categorically that four stakes provided no more strength than three stakes. Yet another noted it did not make a difference because one of the nails, whose job was to be affixed to the support stakes, completely missed the target for which it was intended. Under the ground and out of sight, yet another phenomenon was occurring. Due to the heavy rains and perhaps a failed irrigation line or two, the sandy soils failed to hold onto the root system and simply let go of the tree. No external support system could have held the palm tree in an upright position.

How do you occupy yourself while waiting in the lobby for check-in? Read, people-watch, check your email, or go to the bar? One woman from Michigan decided to spend this time investigating some attractive lobby plants. She cut off a piece of one plant she particularly liked, only to find her hand covered in smelly white sap afterwards. She immediately tried to wipe the sap onto a nearby couch cushion. When that didn’t work, she opted to smell the substance on her hand, and when this yielded no answers, she tried tasting the sap and promptly fell into the initial stages of anaphylactic shock. She then tore through the lobby, grasping wildly at her throat, jumping up and down, and manhandling anyone or anything that crossed her path. Emergency services were quickly summoned, but paramedics initially met with little success as they tried CPR and the Heimlich maneuver. Then they noticed the plant cutting and immediately administered an anaphylactic remedy. Later, the dangerously curious guest checked into her room after a brief stint in the ER.

Of course some folks cannot go on vacation without their best friend. In the guise of a service animal, but not fooling anyone in management of the Presidential room she reserved, this prized Afghan hound looked the part of the blue ribbon winner at the Westminster Dog Show, with her long and lovely pure white coat. This regal K9 eventually had to do her business, and nothing short of the finest display of turf grass would suffice for this necessity of life. No attention is paid to the sign posted on the lawn: Pesticide Treatment-Stay Off. This is a very unique animal, and the chelated iron, still dripping from the blades of grass to which it was applied for instant green-up results, stained the impeccably coifed long white coat. I’m guessing here that the owner went for one of those new short hair cuts that are such the rage among the coterie of elite dog owners.

Have you noticed the lengths to which corporate America will go to demonstrate that it is green? Not to be outdone, one resort mass-planted a ground cover of Japanese xeriscape foliage known as Euphorbia milli, or ‘crown-of-thorns’–with an emphasis on the word “thorns.” To be sure, this is a beautiful plant, with small green leaves and beautiful pink blooms. It does not grow much higher than eight or ten inches and will survive on rainfall alone. It has few, if any, insect problems and doesn’t tend to host diseases. But there are those pesky thorns, lots of them, long and very sharp. And, as a lady from Michigan discovered, its sap can truly do a number on you, especially when the sap gets into your eyes. Along the pathway leading to the children’s pool, a child attempted to pick a flower for his mom. After impaling his finger on the thorns, he instinctively reacted by jerking his hand away from the plant. Out came the sap. Then, in the midst of screaming and crying, the child wiped his eyes with the finger covered with sap and at least two protruding thorns. The child unfortunately will now wear a patch over one eye for the rest of his life.